Provider Demographics
NPI:1164509527
Name:MCNABB, JESSICA LEE (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:MCNABB
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1686 HIGHWAY 1176
Mailing Address - Street 2:
Mailing Address - City:BUNKIE
Mailing Address - State:LA
Mailing Address - Zip Code:71322-7402
Mailing Address - Country:US
Mailing Address - Phone:318-405-0020
Mailing Address - Fax:
Practice Address - Street 1:1510 NAPOLEON ST
Practice Address - Street 2:
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-2320
Practice Address - Country:US
Practice Address - Phone:337-468-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3264101YP2500X
LA1059106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist